Meet the women on the front line of cancer

Cancer. Most of us know someone – a friend, parent, sibling, grandparent, friend of a friend – who has suffered from this terrible, life-shattering disease. It affects millions of lives, which is why this Saturday, 4th February, World Cancer Day will seek to unite the world’s population in the fight against it.

The statistics are bleak: 8.2 million people die from cancer worldwide every year, of which 4 million are under 69. And with one in two of us expected to suffer from cancer, the fight against this terrible disease has never been more important.

Every day, thousands of unsung heroes work against cancer, diagnosing, treating, and caring for sufferers and their families as they go through the toughest time in their lives. These are the women fighting on cancer’s front line.

THE PHYSIOTHERAPIST

Macmillan

Claire Lait is a specialist cancer physiotherapist from Gloucestershire

“As a triathlete, I understand the value of physical activity, so helping people become active again after a terrible illness is a very rewarding job.

I work four days a week for Macmillan supporting people with breast, prostate, and colorectal cancer and two days a week running a private clinic for anyone with a cancer diagnosis.

I see patients at various stages of treatment. Common problems include pain, fatigue, and restricted movement. For example, breast cancer sufferers often report problems with their shoulders, those with head and neck cancer have neck pain and stiffness, and people with Non-Hodgkin lymphoma can develop a dropped head posture because the radiotherapy creates tightness. We do a lot of hands-on work, including stretches and exercises, with the aim of getting people’s strength, balance, and movement back up after illness.

Typically, I see people five or six times, but it varies, and sometimes I see people whose problems have recurred two or three years down the line. When people come to see me they are as low as they can get and don’t know how to get themselves back on track. Doctors and nurses give patients a lot of negative information, but in my job it’s all about the positive. I give people hope, and if a patient can’t get back to how they were, then we’ll figure out what we can do. It’s an amazing job.

Patients let you into their lives – you see the good, the bad, the ugly - and it’s an honour to help people when things are really tough. Often people come with emotions they’ve had previously which a cancer diagnosis makes them want to resolve. In fact, I’m known among my colleagues as the one who always had a box of tissues at the ready!

I become close to lots of my patients. Years ago I got emotional about a young lady, who was a similar age to me and had children the same age. I was so sad when she later died. On the other hand, though, seeing people having fun and getting back on track makes me so proud – it’s an incredible feeling.

Cancer diagnoses destroy people and families, so to be able to help someone be themselves again using just my knowledge is very fulfilling.”

THE DIETICIAN

Macmillan

Michelle Waldie is a specialist dietician working in Leeds

“I work in a team of three with a clinical nurse and a speech and language therapist. We see patients who’ve finished their treatment for head and neck cancer, and support them for as long as they need.

As a dietician, I advise patients who have acute side affects from chemotherapy and radiotherapy. Dry mouth, pain, difficultly swallowing certain textures, and a risk of food or fluid going into the lungs are common problems. Some patients need to be tube fed.. Not everyone can get back to the diet they had before treatment, but my ultimate goal is to get them as close to normal as possible.

When I first meet a patient, they’ve often just finished a seven-week course of radiotherapy. They feel the worst they possibly could, unwell and frustrated, and they just want to get better. I want to tell them that they’re going to be fine in two weeks, but it doesn’t work like that. It can take up to a year before people feel more like their normal self.

I see five patients a day for an hour each. Eating and drinking is such a loaded topic – our whole lives are focused around consuming, so when you can’t do it properly, it’s isolating. I had a patient – a strong, tenacious lady - who has now been discharged, who’d had two rounds of treatment. We weren’t sure how well she was going to do, but she had a really positive outlook. She came to our annual Christmas meal and it was the first time she’d eaten a meal in public since her treatment. Some patients might have issues with dribbling, making them self-conscious, and others need modified diets that they can’t easily get in a restaurant. They also need lots of sauces and fluids in their food, so eating out or with friends is difficult. This lady told me the Christmas meal had given her confidence to go out and have other meals, which is amazing

Working with Cathy, our nurse, and Jen, the speech and language therapist, means we can take a multifaceted approach. Some people can’t eat and drink properly because of pain, so Cathy can offer advice on the right pain relief, so they eat more comfortably. Or if there’s a risk of choking, Jen can examine the person’s swallow and make sure they are safe with a particular texture. I make sure people aren’t losing weight and muscle, and are keeping their strength up. It’s a team approach to getting people back on track.

Patients have said they would have fallen off the edge of the cliff without our support, so helping them to rebuild their lives and providing them with the tools to return to normality is amazing.”

THE NURSE

Sheralyn Holmes is a neuro oncology clinical nurse specialist at Northampton General Hospital

"To me, nursing isn't just a physical job. I see myself as an advocate for patients – somebody in their corner to help them through every stage of their cancer journey.

My relationship with patients starts at diagnosis - so I meet them, make sure they’ve got my contact details, pass on information, and just be there for them at the start of their journey. Sometimes patients want to know everything they can, others are upset and just need some time to take things in.

I have clinics on Mondays, Tuesdays and Wednesdays alongside the consultant. Once the consultant has finished their review, I sit down with the patient to see if they’re struggling with anything or if there’s anything they need. I spend a lot of time with new patients, answering questions and going through the benefits they’re entitled to. On Fridays I hold my own clinic. I keep my phone on so I can always answer any patient calls, too. It’s a very frightening thing, a cancer diagnosis. It’s important for patients to understand their treatment because it takes away a lot of the fear.

I had one patient who really wanted to get things off his chest - he said I always made him cry, but in a good way! He found he felt better for having spoken about things. Patients often say that - there are things they want to talk about that they're afraid to tell their families, so it’s important that we’re there to have those conversations.

I advocate for patients, signpost, and explain information, using a holistic approach to assessing their needs. I liaise with other people and teams in the community so that patients receive a joined-up experience. One of the things I aim to prevent is unwanted hospital visits, so I change their medication and fax a new prescription over to their GP.

I find nursing incredibly rewarding. A few years ago, I studied to gain a BSc in Science. I now have my own nurse-led clinic and review all patients on treatment, which helps to reduce waiting times in the clinic. My patients and their families know that they can always call me. Even if I can’t sort everything out, I can listen. It’s good to know that I can take some of the stress and fear away. I’m a big fan of yoga so I like to unwind with a class once a week and I go to rehearsals for the hospital choir as well - belting out a song or two on a Tuesday night does you the world of good!’

THE VOLUNTEER

Macmillan

Michelle Sykes volunteers on the Macmillan Support Line

I have a full time job in Macmillan’s PR team, but I’ve also been volunteering one evening a week on the charity’s telephone line since July 2016. It’s only two hours every Tuesday, but I know that every little helps.

I decided to start volunteering because I wanted to understand the real stories behind my day job in PR - to do something more meaningful to understand how Macmillan helps people.

I trained for a month and am on the front line team - we're the ones who pick up the phones. We can deliver emotional support and be a shoulder to cry on, but if the query is specialist, we refer it. We’ll put a medical question through to a nurse, or a financial query about, say, how to get a grant for new clothes, to an expert. Similarly, if they need more time off than their boss is willing to give, we have a work support team. I wouldn’t even try to answer any of those questions myself. In some ways my role is to field calls, but you do get a lot of people who just want to talk.

My first calls were terrifying, but my supervisor, Ben, was lovely. He listened in on a few calls until I got the hang of it, then let me go it alone. It’s scary, because ultimately you don’t know who is going to be at the other end of the phone and all you want to do is make sure you do a good job. It’s a lot of pressure but I’m used to it now.

My first call was with somebody who needed medical support for a family member, but there have been a couple of calls I’ve found really tough. The first was a woman the same age as me whose best friend had cancer, and she didn’t know how best to support her. I thought: “that could be me”. Another was just so distressed, and I felt really sad for her. That said, you have to try not to dwell on what you could have said or done. Sometimes, I have to go home and watch rubbish TV just to decompress.

Volunteering gives me hands-on experience with the people Macmillan help, enabling me to do my job better. When the media team ask if something in the news is relevant to our patients, I’ll say: “Yes, two people called me about that yesterday”. I bring first hand experience to the job.

The most upsetting calls are from bereaved people, or those whose loved one has a terminal diagnosis, and there’s not much you can do to help them. All sorts of people call – siblings, daughters, husbands, in laws - looking for help and advice for ill relatives. Other times ill people call who’ve tried to be stoic to their families, but let it all out to you because you’re removed from their life. It’s sad, but if they hadn’t called, they might carry the burden of their feelings alone. I never rush anyone off the phone, and sometimes spend 45 minutes talking to one person. Of course, some people have no friends or family, so I’ll spend longer on the phone to them. I often tell people to call back the next day, so they know they’re not alone.

No two calls, people, or cancers are the same and you just have to do your best with the situation. It’s intuitive, really. One lady said she was sick of people telling her there was light at the end of the tunnel. We ended up having a conversation about people not knowing what to say.

Although some calls are hard, I always leave with a sense that I’ve helped someone, which is a nice feeling. Working on cancer’s front line is quite daunting, but making a positive difference to whoever is on the other end of the phone is all that matters.”

THE OCCUPATIONAL THERAPIST

Macmillan

Sarah Hodge is an occupational therapist from Lincolnshire

“When I was 9, I was diagnosed with juvenile chronic arthritis. All anyone told me was to stop doing the things I enjoyed. But there was one exception: my occupational therapist. She asked me what I wanted to do. I was amazed, and told my mum I wanted to be like her when I grow up. Now, I am.

In a nutshell, I work with cancer patients to help them live their lives as independently as they’d want to, and have been doing so since 2010. Together, we come up with a plan or set goals as to what they’d like to achieve, working with people from diagnosis, during treatment, to end of life care, and in remission. Sometimes I could be working to help a patient sit up or brush their teeth, other times my job is to help someone get back to work, so I work with people with totally different needs.

We assess patients physically and emotionally and then work with them and their families to achieve their goals. Working with people who are going through the most awful time in their life is difficult. We have resilience training and are taught techniques to deal with difficult emotions. That said, while patients and families can be in a horrendous situation, we often come out of an assessment laughing. We’re helping people do what they want to do, and achieve things they didn’t think they could. It sounds strange, but it can be positive.

One lady in particular, diagnosed with a terminal brain tumour, was referred to our service. She was weak on one side and bedbound, but we worked with her for seven months to help her walk again. She loved painting but had stopped, but with arm and sitting posture rehabilitation from us, she joined an art group with her friends. She even went swimming with her sons. The last time we saw her, before Christmas 2016, her family had visited and she’d been for a meal, and done some painting. Sadly she died on Boxing Day. It was a real shock, but the quality of life she’d had up until that point was fantastic.

We’re enabling the families to spend quality time with their loved ones, too. Knowing their mother, for example, spent her last months doing what she wanted helps families to cope. However, it is awful when a patient you’ve worked with dies. We’ll have worked with them for a long time and people say we are part of the family.

As a therapist, there’s so much we can do to help people live fuller lives. We are needed now more than ever, as more people are living with cancer as a chronic condition. Every day is different and there are always new challenges. I’ll be doing this forever.”

Macmillan Cancer Support is here on World Cancer Day and all year round to support people living with cancer and their loved ones. Our Online Community can be found at community.macmillan.org.uk. If you need someone to talk to, the team on our Support Line are here to listen. Call 0808 808 00 00, Monday to Friday, 9am-8pm.

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